Described below are the stages of a normal, progressing labor. Every mother’s experience is unique and different, because every child is different and unrrepeatabe! Typically labor takes longer for a first time mother and then if she has more children, labor seems to be shorter. But again it varies from birth to birth, cherish the one you have!
Pre-Labor:This is the stage that occurs at the very end of the third trimester. Pre-labor can start days or hours before active labor kicks in. It can start and stop as well. A woman will most likely still be able to do her daily functions and will be able to be distracted from the pre-labor contractions. This is when the cervix is moving forward, thinning out and softening so the baby can come through the birth canal. The contractions are non-progressing,meaning they do not get stronger, longer, or closer together.
Early Labor :(0-3) You may or may not notice that you are in this stage of labor.
This stage typically lasts 2-24 hours. Contractions are starting to get longer, stronger and closer together and do not go away if you lay down.
“3-5”: This is what Penny Simkin calls the “moment of truth”, because this is when the mother realizes she cannot control labor. If she is able to “surrender” during this stage she is much more likely able to cope with the rest of labor.
Things the woman may need:
***When you get checked into the hospital and settled in your room, you can dim the lights (this helps relax the body), ask the nurses to talk quietly, advocate for her, and you can politely meet the staff at the door before entering the room to prevent the mother from losing focus. You also have the right to ask for a different nurse if needed.
****It is not abnormal for labor to slow down once you get to the hospital, due to the bright lights, unfamiliar people, loud noises etc. In order for the interplay of natural hormones to continue, the mother must feel safe, private and relaxed.
*****Remind her to hydrate! Even if she doesn’t want much.
****The key to labor is not just one position, but changing positions, using gravity, balance and mobility to work with your body to birth baby
*****She will start needing all of her mental capacity to focus on labor, try to prevent any interruptions. Ask only yes or no questions, but never during a contraction. Ask if something is working in between the contraction and she can tell you yes or no.
The mother’s job is only to tell you what she needs, she may make noises, say things she may not normally, etc. but this is her way of coping. I suggest you come up with a “code word” for if she really wants pain relievers of any sort.
****BRAIN: Benefits, Risk, Alternatives, Intuition (Holy Spirit), Nothing. At any point in labor you can always ask the staff to have a minute to discuss and/or ask what the benefits, risks, and alternatives are in the situation. Listen to the Holy Spirit and ask what would happen if you did nothing.
Active Labor: (6cm-8/9cm) This is when dilation speeds up, which means intensity, frequency and duration of contractions also picks up! Contractions may last 60 seconds or more and come every 4 minutes or less apart. This stage normally lasts 30 minutes to 6 hours.
*** If baby does not seem to be descending in the pelvis, can hold the abdomen up and in (like a tuck) as the baby may be on the pubic bone or shake the apple tree with rebozo or thin sheet. Do each move for 3-6 contractions each.
Transition: Dilates from 8/9-10cm. Contractions can last 1.5-2 minutes long and are closer together/little rest in between. This stage normally only lasts 5-30 minutes. At this stage the baby’s head moves within the uterus, through the cervix, and down into the vagina. She may start to shake or vomit, have cramps in her thighs or pressure in the pelvic area. Her skin may tingle and may not like being touched in this stage. She may feel the urge to push (if she is not yet fully dilated the caregiver will most likely tell her to do small breathes and bear down lightly. This will prevent her cervix from swelling and causing her labor to slow down)
***May or may not get a resting stage before an urge to push. Enjoy this stage and take advantage of it! It normally doesn’t last over 30 minutes. It is when the baby has descended and the uterus is shrinking back down around the baby to be able to effectively push them out.
***If the mother is fully dilated, but the baby has not dropped down into the pelvis yet can try doing a side lying release, shake the apple tree with the rebozo or thin sheet or supported apple tree. If she has an epidural, use peanut ball to “rock the boat”. Do each move for 3-6 contractions each.
Pushing! This stage typically lasts 30 minutes to 3 hours. Will feel the urge to push, may feel like a big poop. To prevent tearing, pushing only when you have the urge/contraction is best. This is an involuntary action that your body knows what to do to get the baby out. Gradual pressure on the stretching of the vagina is better and will put less pressure on the baby’s head. Will feel a lot of pressure, but less “pain” perse from the contractions. When the baby’s head “crown’s” it will sting the vaginal opening due to stretching.
Placental Stage: The placenta will separate from the uterine wall and come out of the vaginal opening. This will occur with a few contractions, sometimes the mother doesn’t notice while other times she will. They are not like active labor contractions though and she may be too focused on holding your baby to notice. It may feel like sharp cramping. Typically the placenta will be out in 15-30 minutes after birth. The caregiver will ensure the entire placenta is present to ensure nothing is left inside the uterus that could cause infections. The umbilical cord is cut at this stage too (if you want to wait until the cord is done pulsing before you cut it, you will need to let your doctor know that beforehand). The caregiver will often firmly massage the mother’s abdomen to ensure it is firming back up (she is often very uncomfortable) and will monitor her bleeding.